| Healthcare Bill Part III; Obamacare | |||||||||||||||||||||||||||||||
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| Tweet Topic Started: Mar 3 2014, 02:20 PM (48,663 Views) | |||||||||||||||||||||||||||||||
| Baldo | Jun 1 2014, 12:42 PM Post #631 | ||||||||||||||||||||||||||||||
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Friday while discussing Kynect, the state of Kentucky's healthcare exchange, with local reporters, Sen. Rand Paul (R-KY) pointed out several upcoming problems including Kentucky medicaid roles being increased by 50 percent and the coming realization by health care providers that low-income patients who's insurance is heavily subsidized by the federal government will not be able to pay large deductibles being offered by the plans on the state exchanges. That sure looks like a winner. Regarding the demise of employer based insurance Emanuel told Fox News, “it's going to actually be better for people. They'll have more choice, most people who work for an employer and get their coverage through an employer do not have choice." So the liberal Dr. Emanuel, another Chicago Thug along the lines of his brother, is actually trying to tell us the Fed Govt can run Healthcare better with more options. PSST Somebody has to pay for it, somebody has to deliver it. Either he is an absolute fool or just another Obama Liar. I suspect the 2nd door. |
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| kbp | Jun 2 2014, 09:00 AM Post #632 | ||||||||||||||||||||||||||||||
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Food for thought... Some discussion on the reimbursement issue identified that the IRS could hit employers for a penalty of $100/day/employee or $36,500 per year per employee. The penalty for not insuring any employees is $2,000 per employee. The average cost of the employer to provide insurance is >$5,000/year. Do the math for the employer! This is a recipe for a nightmare. We'd see an overload on the exchange... When the employer mandate hits, we could witness: the insurance companies in the exchange chasing loads of new applicants; those companies holding an incentive to stay in with low rates losing money until employers dump or avoid employee coverage; and the initial transition will kill employee disposable income and taxes will increase. Have we witnessed the delays used to tweak the process so the big load from the employer mandate will fall in place on voters that have grown more accustomed to the new system, avoiding the political fallout it would encounter if that system was not fully implemented? |
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| Baldo | Jun 2 2014, 09:35 AM Post #633 | ||||||||||||||||||||||||||||||
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Unfortunately for Obama & us there is this thing called paying for things. It now looks pretty clear there won't be any reduction in the cost of Healthcare despite all the promises & saying how a better system will save money. Obama-care's funding was a silly plan, thought up by liberal attorneys & political hacks who are used to billing & have somebody else create the capital. Even if I were assume that the whole goal was to turn insurance over to the Feds, somebody would still have to pay for it. It is cost & how to pay for it. You simply have to pay for all of this. That burden will come down on the economy with businesses & individual taxpayers. there is no one else. It is Small Business(Less than 500 employees) that creates the largest share of employment. From what I have read they are not hiring in numbers large enough to expand our economy. Sure Wall Street, Big banks, UAW Unions, & Govt Workers are doing well, mainly because of all the borrowing & cheap money the Fed is creating and they spreading it to them. But what about the Middle Class? What about Main Street America? I care about this country and the future. Obama has done little to nothing to make Middle America better or more prosperous. In fact I believe he has made it worse. His policies are that of Stop, make things scarcer. He is a Marxist at heart and like all good Marxist uses existing wealth & taxes to create the future of redistribution which always turns out to just bring the middle class downward while rewarding the rich supporters of Marxism. Build into Marxism is the taking away of individual initiative which claims is one of the reasons for the downtrodden classes. It always fails. He promised Health-care for all. Hooray! But do the masses understand he didn't say what kind of Healthcare? Look at the VA for a real world example of the future. Individual initiative & personal responsibility is the only way in the long road which creates prosperity |
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| kbp | Jun 2 2014, 10:03 AM Post #634 | ||||||||||||||||||||||||||||||
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Should all employers dump coverage to the exchange, in theory it is still a private marketplace. The difference, besides taxes and management for coverage, is that Big Brother controls it and we'd see a major redistribution through subsidies. It's difficult to see where this is going. |
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| Baldo | Jun 2 2014, 10:07 AM Post #635 | ||||||||||||||||||||||||||||||
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| Baldo | Jun 2 2014, 10:32 AM Post #636 | ||||||||||||||||||||||||||||||
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THE OBAMA PARADOX The ritual started in earnest last fall in the midst of the biggest humiliation of Barack Obama’s presidency, the failure of the health care website. Anytime he heard a sliver of good news, the president reacted the same way: He knocked on the polished cherry wood table in the Roosevelt Room. It’s a small thing, almost a nervous tic, but Obama’s habit of knocking on wood during Obamacare meetings had become notable, something that close advisers talked and even joked about among themselves. Obama had always projected the aura of a deeply confident man, someone who on the basis of past experience was justified in assuming that good luck just naturally happened to him. But in the second term, confronted by recurring setbacks and regular reminders of the limits of his power, he began to convey a sense that even hopeful news might be ephemeral, a mirage....snipped http://www.politico.com/story/2014/06/the-obama-paradox-107304.html Gladstone Gander is a character created by Carl Barks, first introduced in the story "Wintertime Wager" in Walt Disney's Comics and Stories #88 (January, 1948). He is a lazy and infuriatingly lucky goose who never fails to upset his first cousin Donald Duck. Obama's luck has run out as he finally actually has to produce results. |
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| kbp | Jun 2 2014, 11:00 AM Post #637 | ||||||||||||||||||||||||||||||
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John Sexton, from Breibart, is one of a few people I follow on Twitter to track healthcare news.... |
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| Baldo | Jun 2 2014, 01:15 PM Post #638 | ||||||||||||||||||||||||||||||
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Think Tank: VA Scandal Gives Glimpse into Single-Payer System Conservative think tank American Action Forum put forth research Monday examining the efficiency of single-payer, government-run health care. The report cites the recent Department of Veterans Affairs scandal as a likely consequence of the bureaucratic system, calling into question whether a single-payer system can be an effective system. According to AAF’s research (here): "The VHA boosters were right about one thing: The VHA is a model for a single-payer, government-run health care system. It is a model for how easy it is to manipulate performance measures for years without being detected. The system costs more than other health care options but data are selectively reported to make it appear that it costs less; bureaucratic manipulation of performance data make the system appear to be working well; and administrators collect their bonuses – while veterans die awaiting care. There is a tragic human cost to this bureaucratic manipulation, but that cost does not show up in official figures. The deaths – or extended illnesses, disabilities, and unnecessary discomforts – of veterans on the unofficial VHA waiting lists didn’t show up until whistle-blowers started to leak the truth. It is these human costs which are the true price of a single-payer, government-run health care system." http://freebeacon.com/issues/think-tank-va-scandal-gives-glimpse-into-single-payer-system/ |
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| Baldo | Jun 4 2014, 01:07 PM Post #639 | ||||||||||||||||||||||||||||||
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BREAKING: BREAKING: Data discrepancies in health care signups affect 2 million people, could jeopardize coverage.— The Associated Press (@AP) June 04, 2014 Gee, that's a surprise! 
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| Baldo | Jun 4 2014, 01:20 PM Post #640 | ||||||||||||||||||||||||||||||
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Data discrepancies in health care sign-ups WASHINGTON (AP) — More than 2 million people who got health insurance under President Barack Obama's law have data discrepancies that could jeopardize coverage for some, a government document shows. About 1 in 4 people who signed up have discrepancies, creating a huge paperwork jam for the feds and exposing some consumers to repayment demands, or possibly even loss of coverage, if they got too generous a subsidy. The 7-page slide presentation from the Health and Human Services department was provided to The Associated Press as several congressional committees are actively investigating the discrepancies, most of which involve important details on income, citizenship and immigration status. Ensuring that health care benefits are delivered accurately is a top priority for HHS nominee Sylvia Mathews Burwell, whose confirmation as department secretary is before the Senate this week. Responding to the document, administration officials expressed confidence that most of the discrepancies can be resolved over the summer. Nonetheless, HHS has set up a system to "turn off" benefits for anyone who is found to be ineligible. Julie Bataille, communications coordinator for the health care rollout, said most of the discrepancies appear to be due to outdated information in government files — and the "vast majority" of cases are being resolved in favor of consumers. The government is making an all-out effort to reach those with discrepancies, which officials have termed "inconsistencies." "The fact that a consumer has an inconsistency on their application does not mean there is a problem on their enrollment," said Bataille. "Most of the time what that means is that there is more up-to-date information that they need to provide to us."...snipped http://www.news-press.com/story/life/wellness/2014/06/04/data-discrepancies-health-care-sign-ups/9960761/ They admit 1 in 4. So it is probably worse. Maybe there is a secret list where coverage mistakes are sent. Who know they may get "lucky" and the applicants die first. Having been responsible for purchasing company insurance for over 30 years I have never heard of such incompetency, as 'i's" are dotted & "t's" are crossed with payment of the first month policy before insurance cards are received. That is what competent organizations and agents do. |
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| LTC8K6 | Jun 4 2014, 01:25 PM Post #641 | ||||||||||||||||||||||||||||||
Assistant to The Devil Himself
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They are overlooking enrollment fraud to keep the numbers up. The whole article in one sentence. |
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| kbp | Jun 4 2014, 10:20 PM Post #642 | ||||||||||||||||||||||||||||||
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1.2 million 505,000 461,000 2,167,000 The 2 million in problems is actually 2.167 million, and they do not appear to be resolving the problem. How can they determine the "vast majority" of cases go to the insured? Is that like 20 of the 30 completed? |
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| kbp | Jun 5 2014, 10:33 AM Post #643 | ||||||||||||||||||||||||||||||
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http://dailycaller.com/2014/06/03/obamacare-update-now-even-more-states-report-double-digit-premium-hikes/?advD=1248,153371 Obamacare Update: Now EVEN MORE States Report Double-Digit Premium Hikes Vermont, Connecticut and Arizona Obamacare customers will almost universally be paying higher premiums in 2015, contrary to one of the central promises of the health-care law — lower health care costs. Insurers are upping premiums for all Obamacare exchange customers in Vermont, which is working its way to a single-payer health-care system to encompass the whole state by 2017. MVP Health Care has requested an average rate increase of 15.4 percent, while the only other insurer, Blue Cross Blue Shield, requested average hikes of 9.8 percent. The lowest increase came from BCBS at 5.6 percent for the lowest-quality coverage, a high-deductible bronze plan, while the largest hike was an 18 percent increase for MVP’s silver plan — the most popular health plan type nationally. In Arizona, some health plans are raising rates even faster. While not all Arizona’s Obamacare insurers have submitted proposals, two top insurers are planning to up rates drastically: Cigna proposed average premium hikes of 14.4 percent and Humana requested a 25.5 percent boost. Blue Cross Blue Shield, the largest individual market insurer, expects to file their requests with state officials by the end of June. Connecticut, which currently has just three insurers participating in its exchange, will face two insurers proposing double-digit hikes and one proposing a decrease. Anthem Health Plans requested a 12.5 percent average increase, affecting 66,000 individual health care policies; ConnectiCare Benefits has proposed an 11.8 percent average rate increase for 27,500 policyholders. The one company to propose a decrease, HealthyCT, has just 7,200 members to benefit from its 8.9 percent requested decrease. Unlike its Connecticut competitors, 2014 is the company’s first year of operation and the company still has no claims experience to base its rates on HealthyCT also told state officials it would be spreading out administrative expenses and fees over three years instead of one year, as is typical, making it possible for them to lower their rates. Overall, the track record for the Obama administration on Obamacare premiums is dismal, despite President Obama’s promise to lower premiums by $2,500 annually for the average family. In addition to the hikes released Tuesday, Virginia, Washington, Indiana and Ohio state officials have admitted that Obamacare customers in their states will be hit with cost increases in order to maintain their now-mandatory health coverage. The increases are likely to make it even more difficult for Obamacare exchanges to maintain their newly enrolled customers. While the Obama administration has touted its 8 million sign-ups (months after open enrollment ended, the federal government still has yet to reveal how many people paid for their plans), experts worry whether low-income customers will be able to keep paying their premiums every month. Rising costs may make continued insurance enrollment even more difficult for some. |
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| kbp | Jun 5 2014, 12:42 PM Post #644 | ||||||||||||||||||||||||||||||
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Ties in better with Obamacare, IMO... http://americanactionforum.org/research/veterans-health-administration-a-preview-of-single-payer-health-care Veterans Health Administration: A Preview of Single-Payer Health Care By Robert Book - June 2, 2014 Executive Summary In recent years, many health-reform advocates have cited the Veterans Health Administration (VHA) as an example of how a single-payer, government-run health care system would work. They claim that the VHA's integrated system provides excellent access to high-quality care that a private-sector system cannot match, at a lower average per-patient cost. Not only have recent revelation of off-the-books waiting lists shown that the “excellent access to care” claim is the result of fraudulent data reporting; claims that the VHA has lower costs are also incorrect. While the VHA does spend less per enrollee than the private sector or Medicare, because many veterans have other sources of health coverage, the VHA provides only about one-third of the average enrollee's health care. Adjusting for this factor, we find that the VHA actually spends more than Medicare, and as much as 80 percent more per patient than the private sector. The VHA advocates are right about one thing, however. The VHA is a model of what a government-run, single-payer system would be like. It would provide worse access to health care and dishonest performance figures, while costing more than other health care systems. The VHA and the Single Payer Health System The VHA operates an integrated health system providing care for eligible beneficiaries. The physicians, nurses, and other health professionals – as well as administrators – are all employees of the federal government, which also owns the hospitals and other facilities. It is essentially a single-payer, government-run health care system similar to Britain's National Health Service, although the VHA does contract out a small percentage of its care (for example, primary care providers in areas without a nearby VHA facility). In 2005, Phillip Longman wrote an article on the VHA entitled, “The Best Care Anywhere,”[1] which prompted Paul Krugman to describe the VHA as “a health care system that … provides a helpful corrective to anti-government ideology. For the government doesn't just pay the bills in this system — it runs the hospitals and clinics.”[2] Longman, Krugman, and others claimed that the VHA delivered better health care, at a lower cost, than both private sector health insurance and government-funded programs providing access to privately-provided health care, such as Medicare. Longman followed up with a book-length treatment two years later, subtitled, “Why VA Health Care Is Better Than Yours”[3] and another article (with the provocative title, “Best Care Everywhere”[4]) proposing a VA-like system for all Americans as the “obvious” health care reform solution. However, when we look at the whole picture, we find that the VHA’s costs are not demonstrably lower than those of the private sector; they appear lower only because many veterans have other sources of care, and the VHA provides, on average, only 36 percent of the health care received by VHA-enrolled beneficiaries. When that is taken into account, the VHA is, in fact, more expensive than both the private sector and government programs such as Medicare. The recent revelations of off-the-books waiting lists[5], with veterans waiting 4 to 6 months or longer for appointments when the official books show waits of less than one month[6] also give an insight into how single-payer government systems works. The VA health system is a model for what happens when a health system is run by bureaucrats, using bureaucratic “performance” metrics tied to something other than actual results. Similar phenomena have been observed in other single-payer, government-run systems in other countries as well. The VHA boosters were right about one thing: The VHA is a model for a single-payer, government-run health care system. It is a model for how easy it is to manipulate performance measures for years without being detected. The system costs more than other health care options but data are selectively reported to make it appear that it costs less; bureaucratic manipulation of performance data make the system appear to be working well; and administrators collect their bonuses – while veterans die awaiting care. There is a tragic human cost to this bureaucratic manipulation, but that cost does not show up in official figures. The deaths – or extended illnesses, disabilities, and unnecessary discomforts – of veterans on the unofficial VHA waiting lists didn't show up until whistle-blowers started to leak the truth. It is these human costs which are the true price of a single-payer, government-run health care system. The Hype Nowadays, the VHA is widely admired for an innovative electronic medical records system known as VistA (“Veterans Health Information Systems and Technology Architecture”). VistA is viewed by many single-payer advocates as an example of how a single-payer, fully-integrated, government-run health care system can reduce costs. It is claimed that the VHA is more cost-effective because it is a fully integrated health care system, which can choose the optimal mix of care from different sources – physicians, hospitals, clinical pharmacists, drugs, and devices – in a way that the highly fragmented private system cannot. In theory, the system can provide reminders when patients are due for screening tests, flu shots, follow-up visits, or prescription renewals. Preventive care can become something that is proactively practiced by the health care system, rather than merely a covered service dispensed at the patient’s initiative. In addition, VHA claims that one of the benefits of the system is that if they get a good deal on an alternative to a particular drug, they could switch 95 percent of their patients taking that drug within 90 days.[7] The Truth Now, we know that the VA health system demonstrated how easy it is for a single-payer, government-run system to manipulate performance measures for years without being detected, Most famously, they did this by “shortening” time spent on waiting lists by creating an off-the-books waiting list to get on the official waiting lists – which patients would be placed on only when an appointment was available within the target time frame. In other words, the VA health system is a model for what happens when a health system is run by bureaucrats using bureaucratic “performance” metrics tied to something other than actual results. In this sense, it is not the least bit unique. A few years ago, the hospitals in the British National Health Service (NHS) were found to be meeting a requirement to treat 95 percent of emergency patients within 4 hours of arrival – by keeping patients waiting in ambulances for over an hour (sometimes much longer), until the wait times in the hospital itself dropped below the threshold. This made the hospital appear to be meeting the target, since the clock did not start on the “4 hours” until the patient was actually inside the hospital building. They were, in effect, using the ambulance parking area as an unofficial, off-the-books “waiting list.” There’s a tragic human cost to this behavior that extends beyond the one patient waiting in the ambulance for hours. Keeping patients waiting in ambulances prevents those ambulances from rescuing other patients. Likewise, the deaths, extended illnesses, disabilities, and discomforts of veterans on the unofficial VHA waiting lists did not show up until the truth was leaked by whistleblowers. The VHA has long been praised for its state-of-the-art electronic medical records (EMR) system, its (apparent) focus on preventive medicine and coordinated care, and its (apparent) ability to take advantage of its near-lifetime relationship with patients to focus on keeping patients healthy rather than delivering treatments when they are sick. Now, it turns out that the state-of-the-art EMR system is also very useful for “documenting” performance achievements that are not actually occurring. This will necessarily be the case with any single-payer, government-run system. When dissatisfied patients cannot take their business – and their money – elsewhere, there is no check on internal fraud. While individual fraudsters might occasionally be caught by whistleblowers or investigators, the system will not change and the incentive for fraud will not disappear, because the organization's budget is not dependent on satisfying patients. The Cost to Veterans Did the VHA at least provide care at a lower cost than other health care systems, like private insurance and Medicare? The claim is, in part, that the VHA is more cost-effective because it is a fully integrated health care system, which can choose the optimal mix of care from different sources – physicians, hospitals, clinical pharmacists, drugs, and devices – in a way that the highly fragmented private system cannot. Also, because VHA has a near-lifetime relationship with its patients, it has incentives to make appropriate investments in preventive care and that the VHA can achieve economies of scale; for example, by negotiating lower prices for prescription drugs. When we look at the whole picture, we find that the VHA’s costs are not demonstrably lower than those of the private sector, and in fact appear to be higher. The data required to demonstrate this have not been released to the public since 2004 (though some numbers from 2006 were released by the Congressional Budget Office). In Fiscal Year 2006, the VHA had 7.9 million enrollees, and a total budget authority of $36 billion.[8] This works out to average per-capita expenditures of $4,557. For the entire population of the United States, the Center for Medicare and Medicaid Services (CMS) estimates the total 2006 U.S. health care expenditures to be $2.1 trillion, for a population of 299.7 million.[9] This implies per-capita expenditures of $7,025 – a considerably higher figure. This is even more stunning when one considers that the VHA enrollee population is older, more disabled, and otherwise more likely to consume health care than the average American. However, this neglects a crucial fact: most VHA enrollees have other sources of care. According to VHA’s own figures,[10] the average VHA enrollee receives only 36 percent of his or her health care from the VHA. In VHA parlance, this figure is referred to as “reliance” and is defined as the percentage of an individual VHA enrollee’s health care services that the enrollee received from the VHA, instead of from other sources.[11] When we adjust for 36 percent reliance, we find that if the VHA provided 100 percent of its enrollees’ care (at the same average cost[12]), VHA would have to spend $12,658. Now, instead of appearing to spend 35 percent less per patient than the national average, VHA spends 80 percent more per patient. Of course, this does not necessarily imply that the VHA is cost-inefficient. There are many reasons why the cost per enrollee might be higher for VHA patients than for the general public that are completely unrelated to the VHA’s efficiency. For example, compared to the general public, enrollees are on average older (median age 63), and are therefore more likely to have chronic and age-related diseases. A substantial percentage have service-connected disabilities (including, but not limited to, those from war wounds). This is only partially mitigated by the fact that, having served in the military, they are less likely to have chronic conditions that would have appeared at an early age and disqualified them from service. Due to the age profile of VHA enrollees, it might be instructive to compare the adjusted VHA expenditures to the comparable figure for Medicare beneficiaries, 84 percent of whom are over age 65 and the remainder disabled.[13] In 2006, Medicare spent[14] $401.3 billion to care for a total of 43.1 million beneficiaries for an average government expenditure of $9,311; in addition, Medicare beneficiaries spent an average of $3,103 out-of-pocket for a total per-beneficiary expenditure of $12,414 – slightly less than the “more efficient” VA, and with an older (and possibly sicker) population. These comparisons are summarized in Table 1.
Conclusion The VHA not only delivers worse access to care than its official figures indicate; it also spends more money providing that substandard care. Unfortunately, this should not be surprising to anyone. When VHA officials are given incentives to make performance metrics come out a certain way, they will find a way to make the performance metrics come out that way, even if it does not reflect reality or requires outright fraud. Because the VHA is a government entity, it does not face competition so it cannot lose money by dissatisfied patients deciding to take their business elsewhere. As a result, the metrics become a substitute for reality. A private integrated health system facing a competitive environment could not long survive even if its managers resorted to fraudulent performance metrics. Unsatisfied patients would take their business elsewhere, and the reality would trump the fraudulent figures. So while Longman, Krugman, and other champions of the VHA were advocating it as the model for government-run health care, they were right about one thing: the VHA is, indeed, a preview of what single-payer system would be like. It would provide poor access to health care and likely hide performance failures, all while costing more than other alternative health care systems. [resources for data supplied at link] |
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| foxglove | Jun 6 2014, 08:36 AM Post #645 | ||||||||||||||||||||||||||||||
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I'm not sure this article belongs here but it speaks to government overreach. http://www.infowars.com/new-medical-law-mandates-private-conversation-with-child-before-every-doctor-visit/ New Medical Law Mandates “Private” Conversation With Child Before Every Doctor Visit Parental authority being eviscerated by the state "... She said there was a new policy that would allow a child to access his/her medical records online and the child would be allowed to block a parent from viewing the website. The nurse would also inform my children that the doctor’s office is a safe place for them to receive information about STDs, HIV and birth control. That is what the nurse would be chatting about with my children without any pesky parental oversight..." This is related to my concern that with Obamacare, the funding will be there for school clinics which might bypass the parents' knowledge or permission. Edited by foxglove, Jun 6 2014, 08:36 AM.
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